Lifestyle Monitoring Research Articles

A digital, decentralized trial of exercise therapy in patients with cancer

We developed and evaluated the Digital Platform for Exercise (DPEx): a decentralized, patient-centric approach designed to enhance all aspects of clinical investigation of exercise therapy. DPEx integrated provision of a treadmill with telemedicine and remote biospecimen collection permitting all study procedures to be conducted in patient’s homes. Linked health biodevices enabled high-resolution monitoring of lifestyle and physiological response. Here we describe the rationale and development of DPEx as well as feasibility evaluation in three different cohorts of patients with cancer: a phase 0a development study among three women with post-treatment primary breast cancer; a phase 0b proof-of-concept trial of neoadjuvant exercise therapy in 13 patients with untreated solid tumors; and a phase 1a level-finding trial of neoadjuvant exercise therapy in 53 men with localized prostate cancer. Collectively, our study demonstrates the utility of a fully digital, decentralized approach to conduct clinical trials of exercise therapy in a clinical population.

Generalized and Improved Human Activity Recognition for Real-Time Wellness Monitoring

Human activity categorization using smartphone data can be useful for physicians in real-time data monitoring in sports or lifestyle monitoring. The goal of this research is to develop a methodology that can identify strong machine-learning classifiers applied to various human activity datasets. The first step is pre-processing the data, followed by feature extraction, selection, and classification. Relying on a single dataset does not yield high confidence in the findings. Instead, examining multiple datasets is crucial for a comprehensive understanding, as it avoids the pitfalls of basing conclusions on one dataset alone. Multiple datasets and classifiers are applied in different experiments to achieve improved and generalized human activity recognition performance. Experimental results of the support vector machine (SVM) with its generalized performance of 99% encourage us to use the trained SVM-based model to monitor normal human activities inside the home, in the park, in the gym, etc. enhancing wellness monitoring.

Effect of diet, vitamin D3 and other factors on genital prolapse recurrensce

<p>This study addresses the pressing need for further investigation into risk factors contributing to genital prolapse recurrence, with a focus on factors like younger age and body mass index (BMI) that have been confirmed in the literature. Conducted as a cross-sectional study involving 300 post-operative cases of genital prolapse patients, the case groups comprising 210 individuals received regular gynecological check-ups every six months during the initial five years post-surgery, followed by annual visits, wherein lifestyle, diet, and laboratory values were monitored and adjusted. In contrast, the control group (90 patients) did not undergo post-operative gynecological follow-up. The results indicate that weight lifting, heavy physical work, menopause, constipation, insufficient protein intake, diseases associated with prolonged cough, and BMI are strongly associated with the likelihood of recurrent genital prolapse, while a weight reduction of 5 kg or more exhibits a protective effect (p<0.001). The established regression model proves statistically significant, explaining 84.1% of genital prolapse recurrence factors, with a sensitivity of 84.8% and specificity of 98.8%. These findings emphasize the importance of postoperative lifestyle monitoring, nutritional guidance, and immune support to reduce the risk of genital prolapse recurrence.</p>

Genetic evidence for lifestyle and cardiometabolic factors on the risk of aortic aneurysms: A comprehensive Mendelian randomization study

Background and aimsAortic aneurysm (AAs) is a chronic and severe aortic disease, which is extremely life-threatening due to its delayed diagnosis and a high risk of rupture. In current studies, the association between lifestyle and metabolic factors remains controversial given the complexity of pathogenesis and progression in AAs. Consequently, more reliable and robust evidence should be provided. MethodsGenome-wide association studies summary statistics were obtained for 25 factors (6 lifestyle factors and 19 cardiometabolic factors) and AAs. Univariable Mendelian randomization (UVMR) and multivariable MR (MVMR) were used to estimate the causal effect of these factors on AAs. Meanwhile, mediation analysis was applied to assess the mediated effect of lifestyle on the association of cardiometabolic factors with AAs. ResultsSeveral factors were associated with AA risk, among which triglyceride (TG) (OR = 1.32, 95 % CI = [1.18–1.47], p < 0.001) and high-density lipoprotein cholesterol (HDL-C) (OR = 0.70, 95 % CI = [0.61–0.82], p < 0.001) remain consistently associated with AA risk, with an idependent effect on AAs after adjusting for body mass index (BMI). In addition, TG mediated 15.6 % of BMI effects and 3.7 % of smoking effects on AAs, and HDL-C mediated 5.3 % of the effects of cigarette smoking on AAs. ConclusionsTG and HDL-C may be the most reliable factors in the risk of AAs. More scientific management of lifestyle and regular monitoring for cardiometabolic traits may serve as a new and effective direction for the prevention and control of the occurrence of AAs.

Lifestyle monitoring of declarants in a state of martial law

Lifestyle monitoring of declarants is one of the financial control mechanisms introduced in 2014 with the entry into force of the Law of Ukraine “On Prevention of Corruption”. The National Agency on Corruption Prevention (NACP) was designated as an entity responsible for the lifestyle monitoring of declarants. By the beginning of the full-scale invasion on 24 February 2022, the NACP had completed only a few dozen monitorings. However, after the suspension of mandatory e-declaring as well as full audits of e-declarations due to the introduction of martial law, the NACP intensified its activities on lifestyle monitoring. Until the fall of 2023, the NACP had conducted monitoring based on the direct provisions of Articles 514, 522 of the Law of Ukraine “On Prevention of Corruption” and internal methodological recommendations. In October 2023, the Verkhovna Rada of Ukraine introduced several important amendments to the law on lifestyle monitoring. Following this, the NACP approved a separate Procedure for lifestyle monitoring of declarants which was registered with the Ministry of Justice of Ukraine. The new Procedure defines key terms, establishes a list of information sources for monitoring, determines the manner of recording monitoring results and regulates a number of other procedural issues. Although the adoption of the Procedure is a positive development, the document has certain legal flaws. These include the absence of deadlines for the monitoring procedure, failure to establish auto-distribution of monitorings among NACP employees, and a controversial form of envisaging the final results of the monitoring. The law enforcement practice in lifestyle monitoring is actively developing. Only in 2023 the NACP launched 621 and completed 552 lifestyle monitorings. However, to guarantee full compliance with the principles of legality, legal certainty, and respect for private and family life, the NACP should eliminate the above flaws of the Procedure and adopt special lifestyle monitoring procedures for judges and judges of the Constitutional Court of Ukraine in accordance with the requirements of the law.

Feasibility study for lifestyle monitoring of older adults living independently at home using smart water meter data

Feasibility study for lifestyle monitoring of older adults living independently at home using smart water meter data

A lifestyle monitoring system for older adults living independently using low-resolution smart meter data

A lifestyle monitoring system for older adults living independently using low-resolution smart meter data

INFLUENCE OF DIETARY HABITS ON BODY COMPOSITION IN LEBANESE ACTIVE UNIVERSITY STUDENTS: A GENDER SPECIFIC ANALYSIS

Problem Statement: The unhealthy lifestyle behaviors that university students face comprising sedentary behaviors are associated with weight gain and obesity in this critical life age. Purpose: The purpose of the study is to explore the effect of dietary habits on body composition parameters in Lebanese Active University Students according to gender. Methods: A sample of 200 students from the Lebanese University, faculty of education, physical Education department were studied. The standardized Dietary questionnaire (Turconi et al., 2003) was used to assess the dietary habits of the participants. Body Composition was assessed using the method of multifrequency bioelectrical analysis. Five body composition parameters were assessed: Body Height, Body Mass, Body mass index, Percentage Body Fat mass, and percentage of Skeletal Muscle mass. Results: Lebanese Physical Education students showed satisfactory results and scored above average in the four sections of the nutrition survey. Regarding gender-based classification, males showed better scores in sections of dietary habits and nutrition knowledge, while females showed better scores in physical activity rated level, and nutrition beliefs. Regarding Body Composition, Lebanese students were found in normal body weight. The multiple regression analysis technique showed that the dietary habits factor has mild to moderate influence on body composition specifically on its three tested dependent variables: BM, BFM, and SMM. Conclusion: Findings support the need from educational and health authorities to develop and evaluate health-promotion and obesity-prevention programs for university communities especially for female gender with regular healthy lifestyle monitoring and standardized assessments.

Nursing Interventions in Surgical Patients with Hypertension: Strategies for Optimal Perioperative Blood Pressure Management

This study explores nursing interventions for surgical patients with hypertension, emphasizing strategies for optimal perioperative blood pressure management. Hypertension significantly increases surgical risk, necessitating tailored perioperative care. The objective of this research is to identify and evaluate effective nursing interventions that mitigate these risks and improve patient outcomes. A systematic review was conducted, including randomized controlled trials, cohort studies, and clinical guidelines from 2010 to 2023. The analysis focused on preoperative, intraoperative, and postoperative phases, assessing interventions such as medication management, lifestyle modification counseling, patient education, and monitoring protocols. The findings reveal that preoperative optimization of blood pressure through medication adherence and lifestyle adjustments is crucial. Education about the importance of blood pressure control and adherence to prescribed antihypertensive regimens significantly reduces perioperative complications. Intraoperative strategies include continuous blood pressure monitoring and the administration of antihypertensive agents as needed to maintain stability. Postoperative care focuses on regular blood pressure monitoring, early identification of complications, and patient education to ensure long-term management. The study concludes that a multidisciplinary approach involving nurses, surgeons, and anesthesiologists is essential for effective perioperative management in hypertensive patients. Continuous patient education and engagement in their care, combined with vigilant monitoring and timely intervention, significantly reduce adverse outcomes. These findings underscore the importance of comprehensive, patient-centered nursing interventions in enhancing surgical outcomes for hypertensive patients. Future research should focus on developing standardized protocols and exploring the long-term effects of these interventions on surgical morbidity and mortality.

Evaluation of Non-Invasive Wearable Diabetes Sensors

&lt;b&gt;Introduction&lt;/b&gt; Diabetes management has increasingly emphasised the need for continuous glucose monitoring (CGM) systems, promoting advancements in non-invasive wearable diabetes sensors. This comprehensive review explores the latest developments in this field, focusing on the types, technological advancements, and challenges associated with these devices. The review is structured into distinct sections that examine the current state and future directions of optical, electromagnetic, and transdermal sensors, along with emerging technologies in non-invasive glucose monitoring. The review examines the technological enhancements that have improved sensor accuracy and precision, ergonomic designs for increased comfort, and advancements in data analytics that integrate machine learning for predictive analytics. Comparison of the major challenges such as maintaining sensor accuracy and reliability, ensuring user compliance, safeguarding data privacy, and overcoming cost-related barriers are explored. Furthermore, the paper discusses the promising future directions like the use of innovative materials, the integration of artificial intelligence, and the importance of regulatory and ethical considerations in the development of CGM technologies. This review not only underscores the significant progress made in the field but also highlights the critical need for ongoing research to overcome existing limitations. The implications of these technologies extend beyond individual patient management to broader applications in healthcare and lifestyle monitoring, promoting crucial shift towards more personalised and accessible diabetes management solutions. &lt;b&gt;Material and Methods&lt;/b&gt; &lt;b&gt;Results&lt;/b&gt; &lt;b&gt;Conclusions&lt;/b&gt; &lt;b&gt;&lt;/b&gt; &lt;b&gt;&lt;/b&gt;

The Relationship Between Fast Food Consumption and Daily Lifestyle Changes During School Closures Following the COVID-19 Pandemic: A Cross-Sectional Study Among Adolescents in Korea.

Increased fast food consumption can have adverse effects on health and well-being among adolescents, posing a significant public health concern. The school closures due to the coronavirus disease-2019 (COVID-19) pandemic have led to changes in eating patterns and disrupted a balance diet among adolescents. This study explored the factors associated with fast food consumption among adolescents during school closures due to the COVID-19 pandemic. A total of 1,710 middle and high school students in Gwangju, South Korea participated in a cross-sectional survey. The self-administered questionnaire included items assessing dietary intake, physical activity, sleep, media use, and sociodemographic information. The Patient Health Questonnaire-9, Generalized Anxiety Disorder-7, and three item version of the UCLA Loneliness Scale were also administered. Multivariable logistic regression was used to examine the factors associated with increased fast food consumption. Approximately 34.6% of the surveyed adolescents reported increased fast food consumption during school closures, as well as increased sleep duration, increased sedentary behaviors including watching TV and using the internet, and reduced physical activity. Multivariable logistic regression analysis revealed that fast food consumption during school closures was associated with irregular patterns of main meals and sleep, decreased physical activity, increased internet use, and a lack of daytime adult supervision. Our results highlight the need for dietary and lifestyle monitoring and guidelines to promote health among adolescents, especially during school closures. In conclusion, nutrition intervention programs aiming to limit fast food consumption and enhance healthy dietary habits among adolescents during long-term school closures are warranted.

A Lifestyle Monitoring System for Older Adults Living Independently Using Low-Resolution Smart Meter Data.

Monitoring the lifestyles of older adults helps promote independent living and ensure their well-being. The common technologies for home monitoring include wearables, ambient sensors, and smart household meters. While wearables can be intrusive, ambient sensors require extra installation, and smart meters are becoming integral to smart city infrastructure. Research Gap: The previous studies primarily utilized high-resolution smart meter data by applying Non-Intrusive Appliance Load Monitoring (NIALM) techniques, leading to significant privacy concerns. Meanwhile, some Japanese power companies have successfully employed low-resolution data to monitor lifestyle patterns discreetly. This study develops a lifestyle monitoring system for older adults using low-resolution smart meter data, mapping electricity consumption to appliance usage. The power consumption data are collected at 15-min intervals, and the background power threshold distinguishes between the active and inactive periods (0/1). The system quantifies activity through an active score and assesses daily routines by comparing these scores against the long-term norms. Key Outcomes/Contributions: The findings reveal that low-resolution data can effectively monitor lifestyle patterns without compromising privacy. The active scores and regularity assessments calculated using correlation coefficients offer a comprehensive view of residents' daily activities and any deviations from the established patterns. This study contributes to the literature by validating the efficacy of low-resolution data in lifestyle monitoring systems and underscores the potential of smart meters in enhancing elderly people's care.

Exploring the association between grip strength and adverse pregnancy and perinatal outcomes: A Mendelian randomization study

BackgroundPrevious observational studies have demonstrated an association between grip strength and detrimental pregnancy and perinatal outcomes. However, the causality of this relationship remains uncertain. ObjectiveThis study aims to investigate if there is a causal relationship between grip strength and adverse pregnancy and perinatal outcomes, providing evidence to support active intervention for adverse pregnancy outcomes. Study designA two-sample Mendelian randomization method was used to select GWAS data from the UK Biobank and the FinnGen Biobank as data sources. The inverse variance weighting method was used as the main analysis method. The reliability of the results was verified through sensitivity analysis, including Cochran's Q test, MR-egger intercept regression analysis, leave-one-out analysis, and funnel plot. Independent queues are also used to verify the reliability of the results. ResultsThe study demonstrated a significant positive correlation between genetically predicted hand grip strength and offspring birth weight, specifically left-hand grip strength (β = 0.193, 95 % CI: 0.099–0.286, p = 0.0001) and right-hand grip strength (β = 0.310, 95 % CI: 0.235–0.384, p = 3.27E-16). Sensitivity analysis indicated no horizontal multi-effect, and leave-one-out analysis along with the funnel plot showed no abnormalities. The verification queue also yielded similar results. ConclusionThis study revealed a significant association between grip strength-related traits and offspring birth weight, suggesting a potential protective effect. Moreover, a negative predictive trend was observed for other adverse pregnancy outcomes. Modifying grip strength through an active lifestyle and continuous monitoring of pregnant women's grip strength may have implications for improving pregnancy outcomes. However, further research is warranted to investigate these findings more comprehensively.

Problem aspects of verifying declarations and monitoring the lifestyle

In modern conditions, when the country suffers from a full-scale invasion from the outside, there is no less an enemy within it - corruption. An important factor contributing to the fight against corruption is society, which can help anti-corruption authorities in the fight against such a negative phenomenon as corruption with the help of various means. Among such means, declaration and monitoring of the way of life of officials stand out. This paper will be devoted to highlighting the problem of the imperfection of the current legislation in terms of monitoring the lifestyle of certain categories of persons. Thus, it will be pointed out the problematic decision of the CCU, due to which it was necessary to change the approach to the verification of declarations and lifestyle monitoring. The consequences of this decision will also be analyzed. Thus, according to the current legislation, there should be three separate lifestyle monitoring procedures: the general procedure, the procedure for monitoring the lifestyle of NACP employees, and the procedure for monitoring the lifestyle of judges. However, currently only two orders are in operation: general and for employees of NACP. According to the legislation, the procedure for lifestyle monitoring and full verification of the declarations of judges and judges of the ccu is adopted by agreement with the High Council of Justice. Back in 2021, NACP appealed to the High Council of Justice, but was refused. Therefore, since that time, the order was never adopted. The purpose of the study is to analyze the participation of the public in the use of such anti-corruption tools as the declaration of persons authorized to perform the functions of the state or local self-government, monitoring their lifestyle, and the ways of their interaction with the NACP, as well as to identify shortcomings in the legislation and develop proposals for their elimination.

The Effect of an AI-Based, Autonomous, Digital Health Intervention Using Precise Lifestyle Guidance on Blood Pressure in Adults With Hypertension: Single-Arm Nonrandomized Trial.

Home blood pressure (BP) monitoring with lifestyle coaching is effective in managing hypertension and reducing cardiovascular risk. However, traditional manual lifestyle coaching models significantly limit availability due to high operating costs and personnel requirements. Furthermore, the lack of patient lifestyle monitoring and clinician time constraints can prevent personalized coaching on lifestyle modifications. This study assesses the effectiveness of a fully digital, autonomous, and artificial intelligence (AI)-based lifestyle coaching program on achieving BP control among adults with hypertension. Participants were enrolled in a single-arm nonrandomized trial in which they received a BP monitor and wearable activity tracker. Data were collected from these devices and a questionnaire mobile app, which were used to train personalized machine learning models that enabled precision lifestyle coaching delivered to participants via SMS text messaging and a mobile app. The primary outcomes included (1) the changes in systolic and diastolic BP from baseline to 12 and 24 weeks and (2) the percentage change of participants in the controlled, stage-1, and stage-2 hypertension categories from baseline to 12 and 24 weeks. Secondary outcomes included (1) the participant engagement rate as measured by data collection consistency and (2) the number of manual clinician outreaches. In total, 141 participants were monitored over 24 weeks. At 12 weeks, systolic and diastolic BP decreased by 5.6 mm Hg (95% CI -7.1 to -4.2; P<.001) and 3.8 mm Hg (95% CI -4.7 to -2.8; P<.001), respectively. Particularly, for participants starting with stage-2 hypertension, systolic and diastolic BP decreased by 9.6 mm Hg (95% CI -12.2 to -6.9; P<.001) and 5.7 mm Hg (95% CI -7.6 to -3.9; P<.001), respectively. At 24 weeks, systolic and diastolic BP decreased by 8.1 mm Hg (95% CI -10.1 to -6.1; P<.001) and 5.1 mm Hg (95% CI -6.2 to -3.9; P<.001), respectively. For participants starting with stage-2 hypertension, systolic and diastolic BP decreased by 14.2 mm Hg (95% CI -17.7 to -10.7; P<.001) and 8.1 mm Hg (95% CI -10.4 to -5.7; P<.001), respectively, at 24 weeks. The percentage of participants with controlled BP increased by 17.2% (22/128; P<.001) and 26.5% (27/102; P<.001) from baseline to 12 and 24 weeks, respectively. The percentage of participants with stage-2 hypertension decreased by 25% (32/128; P<.001) and 26.5% (27/102; P<.001) from baseline to 12 and 24 weeks, respectively. The average weekly participant engagement rate was 92% (SD 3.9%), and only 5.9% (6/102) of the participants required manual outreach over 24 weeks. The study demonstrates the potential of fully digital, autonomous, and AI-based lifestyle coaching to achieve meaningful BP improvements and high engagement for patients with hypertension while substantially reducing clinician workloads. ClinicalTrials.gov NCT06337734; https://clinicaltrials.gov/study/NCT06337734.

The Cooperation Between Nurses and a New Digital Colleague "AI-Driven Lifestyle Monitoring" in Long-Term Care for Older Adults: Viewpoint.

Technology has a major impact on the way nurses work. Data-driven technologies, such as artificial intelligence (AI), have particularly strong potential to support nurses in their work. However, their use also introduces ambiguities. An example of such a technology is AI-driven lifestyle monitoring in long-term care for older adults, based on data collected from ambient sensors in an older adult's home. Designing and implementing this technology in such an intimate setting requires collaboration with nurses experienced in long-term and older adult care. This viewpoint paper emphasizes the need to incorporate nurses and the nursing perspective into every stage of designing, using, and implementing AI-driven lifestyle monitoring in long-term care settings. It is argued that the technology will not replace nurses, but rather act as a new digital colleague, complementing the humane qualities of nurses and seamlessly integrating into nursing workflows. Several advantages of such a collaboration between nurses and technology are highlighted, as are potential risks such as decreased patient empowerment, depersonalization, lack of transparency, and loss of human contact. Finally, practical suggestions are offered to move forward with integrating the digital colleague.

Factors Associated with Veteran Self-Reported Use of Digital Health Devices

BackgroundDigital health devices (DHDs), technologies designed to gather, monitor, and sometimes share data about health-related behaviors or symptoms, can support the prevention or management of chronic conditions. DHDs range in complexity and utility, from tracking lifestyle behaviors (e.g., pedometer) to more sophisticated biometric data collection for disease self-management (e.g., glucometers). Despite these positive health benefits, supporting adoption and sustained use of DHDs remains a challenge.ObjectiveThis analysis examined the prevalence of, and factors associated with, DHD use within the Veterans Health Administration (VHA).DesignNational survey.ParticipantsVeterans who receive VHA care and are active secure messaging users.Main MeasuresDemographics, access to technology, perceptions of using health technologies, and use of lifestyle monitoring and self-management DHDs.ResultsAmong respondents, 87% were current or past users of at least one DHD, and 58% were provided a DHD by VHA. Respondents 65 + years were less likely to use a lifestyle monitoring device (AOR 0.57, 95% CI [0.39, 0.81], P = .002), but more likely to use a self-management device (AOR 1.69, 95% [1.10, 2.59], P = .016). Smartphone owners were more likely to use a lifestyle monitoring device (AOR 2.60, 95% CI [1.42, 4.75], P = .002) and a self-management device (AOR 1.83, 95% CI [1.04, 3.23], P = .037).ConclusionsThe current analysis describes the types of DHDs that are being adopted by Veterans and factors associated with their adoption. Results suggest that various factors influence adoption, including age, access to technology, and health status, and that these relationships may differ based on the functionalities of the device. VHA provision of devices was frequent among device users. Providing Veterans with DHDs and the training needed to use them may be important factors in facilitating device adoption. Taken together, this knowledge can inform future implementation efforts, and next steps to support patient-team decision making about DHD use.

Design and Realization of Calorify Mobile Application Interface with Augmented Reality Technology

A mobile smartphone is an integral part of the modern world, and not only for communication, but also for the possibility of using it for many other functions, from entertainment to security measures. An important components of mobile smartphone software are mobile applications, the demand for which is growing every year. One of the directions is mobile applications for maintenance, management, monitoring and support of a healthy lifestyle. This work is devoted to the development and implementation of the "fronend" part of the user interface software of the Calorify mobile application of a hybrid type intended for calorie counting. Despite the large number of mobile applications for counting calories, there is a need to develop a mobile application of a hybrid type with more ergonomic design solutions, confirmed by calculating calories based on analytical mathematical dependencies, with the implementation of augmented reality technology by scanning products. To realize the set goal, prototyping was first carried out in the Figma templating environment and the design of the future Calorify user interface was created. Next, modern UI toolkit technology was used in conjunction with the UI builder in the Unity engine to implement Calorify interfaces. UI Builder allows you to visually create and edit user interface resources, such as user interface documents (.uxml) and style sheets (.uss), used with the UI Toolkit. In general, the Calorify application consists of registration, user, main page and bottom menu pages. The scanner is located in the lower menu block, it is the main function of the Calorify application, which is the main difference and novelty of the developed mobile application. This button opens the option of taking a photo of the dish to automatically determine its calorie and nutritional value. This is a quick and convenient way to get product information the process of scanning products in Calorify, which implements augmented reality technology. For further development, it is planned to expand the possibility of registering domains of electronic addresses, to expand the database and filling of pages.

Feasibility and acceptability pilot study of an online weight loss program in rural, underserved communities.

The purpose of this intervention was to investigate the feasibility, acceptability, and preliminary effectiveness of an online weight loss program, EMPOWER, in rural, underserved communities. Adults with a body mass index (BMI) ≥ 25 kg/m2 living in rural counties were recruited through collaboration with University of Illinois Extension. The intervention lasted 1 year including online educations sessions, nutrition and lifestyle coaching, and diet and weight monitoring via a novel web application, MealPlot. Feasibility was measured by enrollment attainment, participant retention, online education session completion, and completion of anthropometric and dietary measures. Acceptability was measured by survey using Likert scales of satisfaction for all program components. Anthropometric measurements, 24-h dietary records, and food frequency questionnaires (FFQs) were measures of program efficacy. Additionally, two interviews were collected for program feedback. Enrollment of 16 participants was attained, however due to higher than anticipated dropout (retention 62.5%, N = 10) at 3-months, 62.5% of the education sessions were completed and 75.0% of anthropometric and dietary measures. The average satisfaction rating for the comprehensive program was 4.2/5 with lowest satisfaction being the MealPlot web application 2.7/5 (N = 11). On average a clinically significant (≥5% baseline weight) weight loss of 6.2 ± 6.0% body weight or 5.7 ± 5.3 kg and improvements to protein and fiber intake at 12 months (N = 10) were observed. A novel online weight loss program showed adequate to strong feasibility and acceptability and preliminary results indicating efficacy among a pilot sample of rural residents. Future studies are required to investigate means of improving retention and reducing the burden on program collaborators.

Glycaemic Variability in Diabetes

Glycemic variability GV pertains to the variations in blood glucose levels throughout a period. In diabetes it specifically refers to the wide swings in blood sugar levels experienced by diabetic patients. Normally blood glucose levels vary during the day in reaction to various factors including food consumption physical activity stress and hormone release. Nevertheless individuals with poorly managed blood sugar levels often encounter more substantial and frequent fluctuations in their glucose levels a phenomenon prevalent in both type 1 and type 2 diabetes. The assessment of glucose variability GV involves various methods encompassing short term measures such as within-day and between-day variations as well as long-term GV typically determined by sequential measurements over an extended period incorporating values such as HbA1c fasting and postprandial plasma glucose levels. Strategies to address glycaemic variability in individuals with diabetes include lifestyle adjustments medication continuous glucose monitoring CGM insulin pump therapy and diabetes education and support.